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Suicide what to do?
- 1. •S suicide •Pprevention • whatcan we do? • Dddd DR.BINOY D.RAJ •
- 2. introduction • Suicide-defined asan act with fatal outcome that is deliberately initiated and performed by the person in the knowledge or expectation of its fatal outcome. • Latin word sui= oneself • cidium=killing
- 3. • Suicide isa mysterious enigma that challenges most people on many levels. • The biggest aspect of challenge is that we can never ask the person who died “ Why? ”
- 4. Myth- once someoneis suicidal he/she will always remain suicidal • Heightened suicidal risk is often short term and situation specific. • While suicidal thoughts may return they are not permanent. • An individual with previous suicidal thoughts and attempts can go on to live a long life.
- 5. Myth-People who talkabout suicide do not mean to do it • People who talk about suicide may be reaching out for help or support. • A significant number of people who contemplating suicide are experiencing anxiety , depression and hopelessness and may feel that there is no option.
- 6. Myth-Most suicides happensuddenly without warning Fact-Majority of suicides have been preceded by warning signs whether verbal or behavioral. There are some suicides that occur without warning. It is important to understand what the warning signs are and look out for them.
- 7. Myth-Someone who issuicidal is determined to die • Suicidal people are often ambivalent about living or dying. • Someone may act impulsively by drinking pesticides , for instance, and die a few days later , eventhough they would have liked to live on. • Access to emotional support at the right time can prevent suicide.
- 8. Myth-Talking about suicideis a bad idea and can be interpreted as encouragement • Given the widespread stigma around suicide , most people who are contemplating suicide do not know who to speak to. • Talking openly can give an individual other options or the time to rethink his/her decision , thereby preventing suicide
- 9. Myth-Only people withmental disorders are suicidal • Suicidal behaviour indicates deep unhappiness but not necessarily mental disorders. • Many people living with mental disorders are not affected by suicidal behaviours,and not all people who take their own lives have a mental disorder.
- 10. Global issue • Closeto 8,00,000 people die due to suicide every year.
- 12. • For eachadult who died by suicide there may have been more than 20 others attempting suicide
- 13. • It wasthe second leading cause of death among 15-29 year olds, claiming 200,000 lives in 2016, topped only by road injury.
- 14. •75%of suicide occurin low and middle income countries
- 18. Suicide in kerala •Suicide rate in kerala-21.5/ lakh population
- 19. epidemiology • Gender difference-males 4 times than women. • SDR in women was 2·1 times higher in India than the global average in 2016 • 71% of women suicide between 15-39 years • Married women-highest proportion
- 20. • Age-increases withage • Mean age- above 45 years • A bimodal pattern for suicide deaths was seen for women , with a peak in suicide rates in younger women and then an increase after 70 years of age. ( lancet public health)
- 21. Marital status-marriage lessenthe risk? • Married women account for the highest proportion of suicide deaths among women in India. • Marriage is known to be less protective against suicide for women because of arranged and early marriage, young motherhood, low social status, domestic violence, and economic dependence. Lancet Public Health 2018;
- 22. • Occupation –highersocial status greater risk • unemployed higher risk than employed
- 23. An emerging threat •Suicide is the second leading cause of death among 15-29 year-oldsglobally.
- 24. • Failure inexaminations led to 2,413 suicides by students in 2016 or seven every day -- accounting for 25 per cent of student suicides. • The National Crime Records Bureau (NCRB) in its 2015 data made a shocking revelation that in India, one student attempt for suicide every hour.
- 25. Risk factors Genetic/biol ogical factors Environmental factors Recentstress (Psychache) psychological pain Block seeing other solutions Overcome the instinct for self preservation Desire of death + deathofalovedone, Psychological /personaliy factors
- 26. BURDEN TO OTHERS (BURDERSOMENESS) SOCIALDISCONNECTION ACQUIRED CAPACITY FOR SUICIDE Desire of death
- 27. Environmental factors • Prolongedstressful life events – GENDER DISADVANTAGE • Exposure to another persons suicide • - COPY CAT SUICIDE • Access to lethal means -drugs/firearms – HIGH BULDINGS,PESTICIDES,KEROSENE • Isolation/lack of social/family support • long-term pain or a disabling or terminal illness • Academic pressures/relationship issues
- 28. Possible signs ofpoor mental health(young) • Frequent absenteeism and poor academic performance. • Frequent irritability and problems with peers and teachers. • Distress due to relationship issues (romantic) • Expressing feeling that they cannot cope .
- 29. Warning signs forsuicide (young) • Talking about committing suicide. • Developing eating and sleeping problems • Withdrawing from friends and social activities
- 30. • Giving awayprized possession • Having made previous suicidal attempts • Taking unnecessary risks
- 31. • Using drugs/alcohol. •Losing interest in personal appearance
- 32. POSSIBLE SIGNS OFPOOR MENTAL HEALTH IN ADULTS • Repeated presentation of medically unexplained symptoms • Repeated visits/admissions in the hospital
- 33. Warning signs forsuicide (adults) • Expresses wishes to die • Looking excessively sad/ moodiness • Sleep problems • Sudden calmness after a period of distress • Poor social activities
- 34. • Increased consumptionof alcohol • Changes in personality and/or appearance • Putting personal business/family in order/making a will • Reckless driving • Recent life crisis
- 35. • Warning signsmay be cry for a help
- 36. How does onehelp? • Notice any of the warning signs?
- 37. Warning signs? • Givingaway prized possession • Having made previous suicidal attempts • Taking unnecessary risks Talking about committing suicide. Developing eating and sleeping problems Withdrawing from friends and social activities Expresses wishes to die Looking excessively sad/ moodiness Sleep problems Sudden calmness after a period of distress Poor social activities Increased consumption of alcohol Changes in personality and/or appearance Putting personal business/family in order/making a will Reckless driving Recent life crisis
- 38. HOW DOES ONEHELP? • Talk about feelings and the behaviours you have seen that cause you to feel concerned. – You don't need to solve the problem or give advice.
- 39. HOW DOES ONEHELP? • Ask about suicide/Take talk of suicide seriously and use the word “suicide.” • Talking about suicide doesn't cause suicide—but avoiding what's on the persons' mind may make him/her feel truly alone and uncared for. • Talking about suicide is the best form of letting the person vent out his thoughts and problems
- 40. HOW DOES ONEHELP? • Listen – Validate distress – Empathetic – Non judgemental
- 41. HOW DOES ONEHELP? . In a crisis • Attempt to develop a strategy to make things better. – How did you cope earlier? • Ensure safety as possible
- 42. HOW DOES ONEHELP? • Get professional help. – Psychotherapy – Pharmacotherapy if indicated – Even when the immediate crisis passes, the risk of suicidal behaviour remains
- 43. System level interventions 1.Mentalhealth promotion and life skill training 2.Restriction of means 3.Student guidance committee 4.Online counselling services. 5.Accessible professional services.
- 44. To conclude • Epidemiology •Risk factors – issues • Warning signs • Interventions – issues
- 45.